Format

Send to

Choose Destination
Pharmacotherapy. 2005 Mar;25(3):345-51.

Low myopathy rates associated with statins as monotherapy or combination therapy with interacting drugs in a group model health maintenance organization.

Author information

1
Anticoagulation and Cardiac Risk Service, Westminster Primary Care, Longmont, Colorado 80305, USA. roberta.shanahan@kp.org

Abstract

STUDY OBJECTIVE:

Because the risk for myopathy increases when 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) are used with other agents known to inhibit cytochrome P450 3A4 in patients with dyslipidemia, we sought to quantify this risk in a diverse, real-world sample of patients receiving statin therapy.

DESIGN:

Retrospective chart review.

SETTING:

Kaiser Permanente Colorado (KPCO), a group model health maintenance organization with approximately 360,000 members.

PATIENTS:

Four hundred sixty-eight patients who were identified as having a diagnosis of myopathy over a 4-year period using KPCO computerized data systems.

MEASUREMENTS AND MAIN RESULTS:

Medical records were reviewed to confirm myopathy cases associated with statin therapy. Of the 468 patients, 61 had received statin therapy before their diagnosis, and 41 (67%) of these patients had confirmed myopathy (documented creatine kinase level>or=1000 IU/L). The prevalence of myopathy was 0.12% with statin monotherapy and 0.22% with statins in combination with interacting drugs. Only 17 of the 41 (41%) patients had confirmed myopathy with no other plausible clinical explanation, such as a muscle injury. Increased risk of myopathy associated with statin therapy in combination with interacting drugs approached statistical significance (p=0.052) but was of minimal clinical significance.

CONCLUSION:

The prevalence of confirmed myopathy in patients receiving statin therapy is low (<1%). Combining statin therapy with interacting drugs (e.g., fibrates) was not associated with a clinically important increase in the prevalence of myopathy. The risk of developing myopathy during statin therapy is outweighed by the benefits derived from the therapeutic effects of the therapy.

PMID:
15843281
DOI:
10.1592/phco.25.3.345.61606
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center